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My dozen reasons for why I run late

Yesterday one of my patients said: 'Dr Sanders why are you always running late?' I was not on good form, having returned from the holiday in hell to post-vacation blues.

A number of responses came instantly to mind. These are my top 12.

1 Read the papers. There are far too many patients and too few GPs. Our list size has exploded (and one less would be good).

2 Patients do not seems to know how long their appointment actually is. My patients can talk endlessly about their state of health.

3 The sore toe that you have swanned in with is 'non urgent'. This is not a walk-in service.

4 You may have been on time for your appointment, your predecessors weren't.

5 A list of lifetime complaints can't be solved in 10 minutes.

6 Join the queue of people outside my door demanding prescriptions to be signed or patients to be phoned back, immediately.

7 I'm trying to follow Balint and Pendleton. Can you do it in 10 minutes?

8 This consultation is being videoed for training purposes.

9 The medical student behind me is being taught didactically, and so asks heaps of useful questions.

10 Deep and meaningful explanations and dissolving raised expectations take time.

11 Occasionally I stop for toileting or fluids.

12 Okay. It's true. After 11 years in the job, I am slowing up. Part of my personal development plan will include the purchase of a clock.

Careful not to run over the appointed time, I restricted my explanation to my top three favourites. You may ponder upon which they were. The patient looked bemused and left. Clearly doc was having another bad day. If she forsakes me and joins another's list, I will wish her well.

I'm sure she will find a local GP who runs perfectly to time, has 48-hour access for

non-urgent appointments and never has to contend with any of the above.

Dr Suresh Sanders

GP trainer

Livingston

West Lothian

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